Nso Roca A P, Baquero-Artigao F, García-Miguel M J, de José Gómez M I, Aracil Santos F J, del Castillo Martín F
Unidad de Enfermedades Infecciosas, Hospital Universitario Infantil La Paz, Madrid, Spain.
An Pediatr (Barc). 2008 Feb;68(2):124-7. doi: 10.1157/13116226.
Staphylococcal scalded skin syndrome is a rare disease caused by Staphylococcus aureus that produces exfoliative toxins. There are few epidemiological data in our environment.
We present an observational cohort study. We review the cases of staphylococcal scalded skin syndrome monitored at La Paz Children Hospital during the last ten years (January 1997 to December 2006).
We obtained 26 patients, 7 in the first 5 years and 19 more in the following years. The mean age at diagnosis was 19 months. Four cases (15%) occurred during the neonatal period. Sixty-seven percent of the cases were diagnosed during spring and summer. Main clinical signs were: erythroderma with blisters and posterior desquamation (100%), perioral fissures (54%), fever (46%), conjunctivitis (42%) and palpebral edema (31%). No significant increases in leukocytes (mean: 11,341/.l) or C-reactive protein (mean: 9 mg/l) were found on blood analysis. Diagnosis was made by clinical findings. S. aureus was isolated in nasal or conjunctival samples on 59% of cases. All strains were sensitive to cloxacillin, clindamycin and vancomycin. The patients were treated with cloxacillin with good progress.
Staphylococcal scalded skin syndrome seems to be more common in the last few years. It must be suspected in children with acute erythroderma and perioral or conjunctival lesions. Treatment with cloxacillin leads to healing without sequelae.
葡萄球菌烫伤样皮肤综合征是一种由产生剥脱毒素的金黄色葡萄球菌引起的罕见疾病。在我们所处环境中，相关流行病学数据较少。
我们开展了一项观察性队列研究。回顾了过去十年（1997年1月至2006年12月）在拉巴斯儿童医院监测到的葡萄球菌烫伤样皮肤综合征病例。
我们共纳入26例患者，前5年有7例，后几年又有19例。诊断时的平均年龄为19个月。4例（15%）发生在新生儿期。67%的病例在春季和夏季被诊断出来。主要临床体征为：伴有水疱和后期脱皮的红皮病（100%）、口角皲裂（54%）、发热（46%）、结膜炎（42%）和眼睑水肿（31%）。血液分析未发现白细胞（平均：11,341/μl）或C反应蛋白（平均：9mg/l）有显著升高。根据临床表现做出诊断。59%的病例在鼻腔或结膜样本中分离出金黄色葡萄球菌。所有菌株对氯唑西林、克林霉素和万古霉素敏感。患者接受氯唑西林治疗，病情进展良好。
葡萄球菌烫伤样皮肤综合征在过去几年似乎更为常见。对于患有急性红皮病以及口角或结膜病变的儿童必须予以怀疑。氯唑西林治疗可实现愈合且无后遗症。
